HomeMy WebLinkAbout178877 10/28/2009 CITY OF CARMEL, INDIANA VENDOR: 360209 Page 1 of 1
ONE CIVIC SQUARE ST VINCENTS EMPLOYEE ASSISTANCEACK AMOUNT: $2,787.75
CARMEL, INDIANA 46032 8401 HARCOURT ROAD
I.
INDIANAPOLIS IN 46260
CHECK NUMBER: 178877
CHECK DATE: 10/28/2009
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUMBER AMOUNT DESCRIPTION
}1205 R4347500 16049 5- 20376299 2,787.75 EAP SERVICE
ST VINCENT EMPL. ASST. PROGRAM
3401 HARCOURT RD
INDIANAPOLIS IN 46260 Date Account Number Balance
10/08/09 5- 20376299 2787.75
*CITY OF CARMEL
LAMB,BARB
CITY HALL 1 CIVIC SQUARE
CARMEL,IN 46032
Please enclose top portion with payment
Rate: 1.75 Number of Employees: 531
ACCT 5- 20376299 PATIENT: *CITY OF CARMEL CHG AMT PAY /ADJ BALANCE
INVOICE 053672913
EMP PROVIDER
10/06/09 OCTOBER 2009 929.25
10/06/09 NOVEMBER 2009 929.25
10106109 DECEMBER 2009 929.25
INVOICE BALANCE: 2787.75 1
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Account 0 -30 days 31 -60 days 61 -90 days >90 days Balance Due
5- 20376299 2787.75 0.00 0.00 0.00 2787.75
PAGE: 1
ST VINCENT EMPL. ASST. M F 9a.m. to 4p.m.
8401 HARCOURT RD Ph: 317 338 -4900
INDIANAPOLIS IN 46260
i o.
Prescribed by State Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
CITY OF CARMEL
k `An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
y kN Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Total
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6.
20
Clerk- Treasurer
„VOUCHER NO. J WARRANT NO.
ALLOWED 20
IN SUM OF
go 1 C10 RQ
ON ACCOUNT OF APPROPRIATION FOR
Board Members
PO #or INVOICE NO. ACCT #!TITLE AMOUNT
DEPT. I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
r materials or services itemized thereon for
which charge is made were ordered and
received except
20
i
ignature
Cost distribution ledger classification if
Title
claim paid motor vehicle highway fund